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1568915106 NPI number — PHYSICIANS CARE OF GROVE HILL LLC

NPI Number: 1568915106
Health Care Provider/Practitioner: PHYSICIANS CARE OF GROVE HILL LLC

Information about “1568915106” NPI (PHYSICIANS CARE OF GROVE HILL LLC) exists in 1568915106 in HTML format HTML  |  1568915106 in plain Text format TXT  |  1568915106 in PDF (Portable Document Format) PDF  |  1568915106 in an XML format XML  formats.

NPI Number : 1568915106 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1568915106",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PHYSICIANS CARE OF GROVE HILL LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "127 CLARK ST STE C&D",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GROVE HILL",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "36451-3050",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "334-636-5311",
    "MailingAddressFaxNumber": "334-636-2280",
    "FirstLinePracticeLocationAddress": "127 CLARK ST STE C&D",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GROVE HILL",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "36451-3050",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "334-636-5311",
    "PracticeLocationAddressFaxNumber": "334-636-2280",
    "EnumerationDate": "08/01/2016",
    "LastUpdateDate": "01/08/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KIDD",
    "AuthorizedOfficialFirstName": "HUEY",
    "AuthorizedOfficialMiddleName": "R",
    "AuthorizedOfficialTitle": "PHYSICIAN",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DO",
    "AuthorizedOfficialTelephoneNumber": "334-636-5311",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QR1300X",
          "TaxonomyName": "Rural Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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